scholarly journals Neurocognitive impairment in Spanish-speaking Latinos living with HIV in the US: Application of the neuropsychological norms for the US–Mexico border region in Spanish (NP-NUMBRS)

Author(s):  
Lily Kamalyan ◽  
Mariam A. Hussain ◽  
Monica M. Diaz ◽  
Anya Umlauf ◽  
Donald R. Franklin ◽  
...  
2019 ◽  
Vol 34 (7) ◽  
pp. 1257-1257
Author(s):  
M A Hussain ◽  
L Kamalyan ◽  
M M Diaz ◽  
A Umlauf ◽  
D R Franklin ◽  
...  

Abstract Objective HIV-associated neurocognitive impairment (NCI) is prevalent and impactful. Yet, there is an absence of published studies that investigate its correlates among Spanish-speaking Latinos living in mainland US- a demographic that represents a large and vulnerable segment of the HIV+ population. The goal of the current study was to examine predictors of NCI among Spanish-speaking Latinos with HIV living in the United States. Participants and Method 153 Spanish-speaking Latinos living with HIV from the US-Mexico border region (Age: M = 38.2, SD = 9.7; Education: M = 10.9, SD = 3.6; 73% female; 56% AIDS) completed comprehensive neuropsychological, neuromedical, and psychiatric evaluations in Spanish. Scores across 7 cognitive domains were converted to a Global Deficit Score (GDS) based on T-scores on individual tests using newly developed, region specific, and demographically-corrected norms for Spanish-speaking Latinos. NCI was determined using cutoff of GDS > 0.5 (39.2% of sample). Examined predictors included HIV disease characteristics (e.g., AIDS status, current CD4 count, duration of antiretroviral therapy (ART) exposure) and psychiatric comorbidities. Results A multivariable logistic regression - including predictors that were associated with NCI in univariable analyses - showed a significant interaction between lifetime history of substance use disorder (LT SUD) and duration of ART exposure, after accounting for AIDS status (LR Chi2 = 3.99, p = 0.046). Stratified analyses showed that among participants who did not have LT SUD, longer ART exposure was associated with decreased NCI (p = 0.01), while rates of NCI among those with LT SUD were not influenced by months of ART exposure (p = 0.91). Conclusions Present findings showed that HIV disease burden and psychiatric characteristics might interact to impact NCI among Spanish-speaking Latinos. Considering these influences may help in the provision of comprehensive care to Spanish-speaking, Latino minority groups that suffer from NCI and HIV.


2019 ◽  
Vol 34 (7) ◽  
pp. 1259-1259
Author(s):  
L Kamalyan ◽  
M A Hussain ◽  
M M Diaz ◽  
A Umlauf ◽  
D R Franklin ◽  
...  

Abstract Objective Latinos in the US are at increased risk for HIV-associated neurocognitive impairment (NCI). Yet, most studies in this group have included English-speakers only. We investigated the rate and pattern of HIV-associated NCI in Spanish-speaking Latinos from the US-Mexico border region by utilizing newly developed norms for this group, and compared it to previously published norms for English-speaking non-Latino Whites and Blacks/African Americans. Participants and Method Participants included 153 HIV+ Spanish-speaking Latinos (Age: M = 38.2, SD = 9.7; Education: M = 10.9, SD = 3.6; 27% female; 56% AIDS) living in the greater San Diego area. Participants completed comprehensive neuropsychological, neuromedical and psychiatric assessments in Spanish. The neuropsychological test battery employed in this study - and used extensively in prior studies of HIV- assesses seven ability domains. Raw test scores were converted to demographically-adjusted T-scores using regional norms for Spanish-speakers, and for non-Latino Whites and Blacks. NCI was defined per established criteria. Results Rate of global NCI was 39% using norms for Spanish-speaking Latinos, compared to 64% with White norms and 18% with Black norms. Using norms for Spanish speakers, domain specific NCI among those impaired was highest in executive function (68%), speed of information processing (65%), learning (51%), and working memory (50%). The pattern of HIV associated NCI varied when norms developed for non-Latino Whites and Blacks were used. Conclusions HIV+ Spanish speakers showed similar rates of global NCI to those in other HIV+ populations, when norms developed for this group were used. In contrast, use of non-Latino White and Black norms resulted in misclassification of impairment. The pattern of NCI differed based on the norms used. Present findings highlight the importance of utilizing norms developed for Spanish-speakers in the US in order to obtain more precise and valid depictions of cognition in this population.


2019 ◽  
Vol 34 (7) ◽  
pp. 1274-1274
Author(s):  
T Scott ◽  
A Morlett Paredes ◽  
M Taylor ◽  
A Umlauf ◽  
L Artiola i Fortuny ◽  
...  

Abstract Objective Adaptations of the Wechsler Adult Intelligence Scale, Revised (WAIS-R) and accompanying norms exist for a limited number of Spanish-speaking populations, but none are available for US-dwelling Spanish speakers of Mexican origin, who make up the largest proportion of Latinas/os in the US. As part of a larger test adaptation and norming effort for Spanish-speakers from the US-Mexico border region, we generated and investigated demographically adjusted interpretive norms for selected WAIS-R subtests. Participants and Method Participants included 183 community-dwelling, primarily Spanish-speaking individuals, aged 20 to 55 (education range: 0-20 years; 58% female), who were residing in the US-Mexico border region. Participants completed the WAIS-R Spanish version (Block Design, Arithmetic, and Vocabulary subtests) as part of a larger neuropsychological battery. Demographically adjusted T-scores were calculated for these subtests using fractional polynomial equations, which controlled for age, education, and sex. We examined rates of neurocognitive impairment (T < 40) in our sample derived from the present demographically adjusted Spanish speaking norms and from the existing WAIS-R demographically adjusted norms for English-speaking Non-Latina/o White and Black adults. Results Based on the normalized distribution of T-scores, the newly developed regional Spanish-speaker norms yielded subtest rates of impaired performance between 13-16% (i.e., within the expected -1 SD). By comparison, the proportion of impaired subtest performances was between 4-6% when applying the existing English-speaking norms to our sample. Conclusions Regional normative data will improve interpretation of test performance on selected WAIS-R subtests for Spanish-speakers living in the US and will facilitate a more valid analysis of neuropsychological profile patterns in this population. Cross-validation with Spanish-speakers in other regions and/or with other national origins is needed.


2019 ◽  
Vol 34 (7) ◽  
pp. 1265-1265
Author(s):  
A Morlett Paredes ◽  
J Carrasco ◽  
M Cherner ◽  
A Umlauf ◽  
M Rivera Mindt ◽  
...  

Abstract Objective To provide norms applicable to Spanish-speakers living in the US- Mexico border region for the Halstead Category Test, a test of executive function. Participants and Method Healthy Spanish-speakers (n = 252) were recruited from the US–Mexico border regions (Age: M = 37.3, SD = 10.2, range 19-60; Education: M = 10.7, SD = 4.3, range 0-20; 58% female). Participants completed the Category Test as part of a larger neuropsychological test battery. Relationships between demographic variables and raw error scores were assessed using Spearman and Wilcoxon Rank-sum tests. Demographically corrected T-scores for the Category Test were normed using fractional polynomial equations accounting for age, education, and sex. For comparison, T-scores were also computed for the Spanish-speaking normative sample using published norms for English-speaking non-Hispanic Whites and African Americans, which were also adjusted for age, education and sex. Impairment rates based on -1SD (T < 40) were calculated using both, published and current, norms. Results Older age was significantly associated with higher number of errors (Spearman ρ = 0.32, p < .001) and higher education was associated with lower number of errors (Spearman ρ = -0.52, p < .001), with no other significant demographic effects. Applying non-Hispanic norms resulted in overestimation of impairment rates in the Spanish-speaking sample (impairment rate: 48% with White norms and 27% with African American norms). This pattern was evident across levels of education except in participants with 13+ years of education, where rates of impairment using African American norms were comparable to those based on the newly developed norms. Conclusions The present study is the first to develop norms for the Category test in a sample of Spanish-speakers in the US-Mexico border region. These norms will provide tools for the assessment of executive function in this population. Research concerning generalizability of norms to other Spanish-speaking populations is needed.


2016 ◽  
Vol 106 (1) ◽  
pp. 119-127 ◽  
Author(s):  
Guilherme Borges ◽  
Cheryl J. Cherpitel ◽  
Ricardo Orozco ◽  
Sarah E. Zemore ◽  
Lynn Wallisch ◽  
...  

2021 ◽  
Author(s):  
James Callegary ◽  
Anne-Marie Matherne ◽  
Sandra Owen-Joyce ◽  
Elia Tapia Villaseñor ◽  
Amy Rosebrough ◽  
...  

<p>Four US and six Mexican border states share significant interconnections in terms of trade, jobs, energy production, manufacturing, and natural resources such as water. The border states have a mutual interest in characterizing groundwater resources shared between the US and Mexico, a task made difficult by scarcity of information. To address this challenge, a number of US and Mexican federal agencies and universities via the Transboundary Aquifer Assessment Program (TAAP) have come together to jointly study the shared groundwater resources of the border region, and to develop the information needed by cities, states, industries and local communities to support decision making and land management.</p><p>Investigations of four binational aquifers selected in the first phase of TAAP are in progress. Carrying out these investigations has created a cohesive binational multi-institutional team of social and physical scientists and established relationships with a broad network of stakeholders. Completed products relevant to the present work include: (1) analysis of the availability and integration potential of binational data sets, (2) aquifer assessments including a review of US-Mexico aquifer classifications (3) development of water-balance models, (4) analysis of aquifer vulnerability to contamination, and (5) a set of protocols and agreements that address the specific physical, legal, cultural, and institutional setting of the US-Mexico border.</p><p>Additional aquifers along the border (estimates of the total range from of 8 to 38) could be investigated, but there are questions as to how to define them, which to choose, and what types of studies are needed. To help answer these questions, we developed a pilot project to investigate and develop methods and tools to assist decision makers and land managers in prioritizing additional aquifers for investigation along the US-Mexico border. First is an approach for rapid assessment of additional aquifers using existing data, published literature, and simple analytical tools including conceptual hydrogeologic model development and precipitation-groundwater lag-correlation analysis. Second, a groundwater modeling platform was developed for use by stakeholders for both learning and planning. Third, in preparation for stakeholder ranking of aquifers for investigation, we conducted a review of multicriteria decision analysis (MCDA) as applied to coupled human-natural resource systems and a review of real-world examples of aquifer prioritization schemes used by governmental entities. Finally, an assessment of uncertainty with respect to knowledge about and trajectory of the coupled human-biophysical system was carried out to aid in stakeholder discussions of prioritization criteria and weighting schemes. These results and tools can be used to support prioritization of any set of aquifers. However, some are specifically designed to address transboundary aquifers and will be used to inform binational discussions regarding prioritization of future aquifer investigations along the US-Mexico border.</p>


Author(s):  
Devon McAslan ◽  
Mihir Prakash ◽  
David Pijawka ◽  
Subhrajit Guhathakurta ◽  
Edward Sadalla

2016 ◽  
Vol 41 (5) ◽  
pp. 756-775 ◽  
Author(s):  
Margaret O. Wilder ◽  
Ismael Aguilar-Barajas ◽  
Nicolás Pineda-Pablos ◽  
Robert G. Varady ◽  
Sharon B. Megdal ◽  
...  

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